Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ellen Kudrow, FNP-BC

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1689054199

Ellen Kudrow, FNP-BC is a Nurse Practitioner in Brooklyn, New York. Qualified in 2014, 12 years ago. Practices with Revived Soul Medical PC, a 15-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New York.

Years since qualifying
12
Licensed in
NY
In the registry since
2015
Specialties on file
2
What do these letters mean?
FNP-BC — Family Nurse Practitioner, Board Certified
A family nurse practitioner certified by the ANCC.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

350 91st St Ste 1A
Brooklyn, NY 11209-5853
Phone: (929) 992-3202
Fax: (929) 323-0474
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 403317 (NY)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence F339008-1 (NY)

Record details

NPI number1689054199
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-BC
Sole proprietorNo
NPI enumeratedJune 1, 2015
Last updated in NPPESJanuary 18, 2026
Certification dateJanuary 18, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Revived Soul Medical Pc — 15 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Brooklyn